Primum Non Nocere. First, do no Harm.
It is the first rule of medicine; should we not extend this to skincare, too?
If you’re not immersed in the sometimes-bizarre world of beauty trends.
The practice of microneedling – may sound strange.
It’s a treatment that comes under many guises.
Dermarolling, derma stamping with PRF or PRP, and Morpheus 8, to name but a few
It also comes with an exhaustive list of benefits for your skin.
If that is the case, why are there so many concerns with this treatment?
Side effects like these that many of our customers and readers have experienced?
- tram marks
- enlarged pores
- excessively oily skin
- accelerated ageing
- erythematous papules
- skin pigment changes
- permanent indentations
- systemic hypersensitivity
- granulomatous dermatitis
- possible tumour formation
- post-inflammatory hyperpigmentation
Please rest assured that scaremongering isn’t our philosophy.
But we can’t ignore the daily emails or the many comments below.
Many have been physically and psychologically scarred due to poorly performed treatments.
So we put together this article to help raise awareness of the risks associated with microneedling facial treatments.
We’ll examine case studies and look at the complications that can arise.
If you are considering having a treatment, you may want to read this article first to ensure you get the best outcome.
So let’s dive right in
What Exactly is Microneedling?
It is a medical microneedling treatment that involves fine, sterile needles that vibrate at high power thousands of times over a few seconds.
The needles pierce microscopic ‘holes’ into the superficial layer of your skin.
These small and controlled piercings create channels or micro-wounds that release growth factors, which are thought to instigate a healing response in your skin, but we beg to differ – more on that later.
Your body responds to this by encouraging the formation of new collagen, elastin, and neovascularisation – the natural appearance of new blood vessels in the dermis.
In technical terms, it takes advantage of your skin’s response to any inflammatory wound.
For example, if you cut your skin, your body’s first line of defence is to deploy white blood cells; these release chemicals that increase the production of components that comprises your skin’s intercellular matrix.
They tell your body to patch the hole, creating new cells at the site of the wound.
A classical wound may be defined as a disruption of tissue integrity; any wounds, whether caused by injury or remodelling, rely on the biological phases of healing: inflammation, proliferation, and remodelling.
They Say: Microneedling is a collagen-stimulating treatment that uses needles to injure your skin; this stimulates collagen and elastin production, improving skin texture, pores, and fine lines.
Naked Chemist Truth: Microneedling tears through the epidermis – your outer layer of skin and creates tiny puncture marks that play havoc with your skin’s natural defence mechanisms; this has to work harder to repair the tiny micro-tears through collagen induction, which causes a whole host of skin conditions.
It does not tighten your skin; it swells it: We don’t believe micro-needling promotes skin collagen. Because when you break down your skin’s protective barrier function with needles, you are causing trauma and temporarily injuring your skin. That tightening effect you are experiencing is actually plump, swollen skin.
It does not create a glowing complexion: That ‘lit-from-within’ glow is, infact, inflammation, which we believe is the source of premature ageing, so it is a big NO in our book.
Here at the Naked Chemist, we always question why break down your protective barrier to build it back up?
We prefer to come from a much more holistic viewpoint, to treat “like with like” with gentle, healing formulas that keep your protective barrier intact and the delicate microflora that makes up your acid mantle healthy – surely that makes more sense?
This is a Painful Procedure
Even a 0.2 mm puncture can cause an inflammatory response in your skin, leading to problems at any depth.
Not only that, but you are effectively injecting active serums at a depth where serums are not meant to go.
Bottom line: If your skin is impaired, red, dry, inflamed, or you have acne inflammation, it requires a super-healthy skin response, and if it is stressed, you are almost certainly at risk of damage, as this study shows (1).
Clemmy from London wrote: “Help, my skin looks worse after microneedling. The treatment felt like it shredded my skin beneath the surface, my once-perfect skin is ruined, and I feel like I could cry; it has lost all firmness and support. I know it has been structurally damaged, and I looked grazed all over. I don’t want to leave the house and after 6 months, it is still not healing. I had no idea about the risks of microneedling.”
Nancy from Australia wrote: “The day after having morpheus8, my face became swollen, and there were scratch-like marks, I was shaking during the procedure! I should have known something was wrong then, and I had bruising. I was told to do a course of peels to eliminate the lines, which sent my skin into inflammation mode. Today my skin has tiny holes and lines in it. With your team’s help and your incredible products, it has been slowly repairing, but it has taken a lot of time and effort, i wished i’d never had this treatment.”
Angela, a client, experienced the following: “I am 43 and this micro needling treatment has left my face inflamed and I am battling severe facial burning. My once smooth skin is sensitive, and my pores are enlarged. I have been to a few dermatologists who have no idea what to do. Your advice is helping to rebuild my skin. I can’t thank you enough. I wish I had known about these microneedling side effects earlier.”
Marian from the USA wrote: “Micro rolling has destroyed my skin. It has left bumps and holes in my face and requires total resurfacing, which I am scared to do. It has dried out my skin and created strange horizontal lines I did not previously have; in short, microneedling at home is UNSAFE. Do not attempt it.”
Jen from Australia wrote: “After having 25 pages of blood tests, my dermatologist was very thorough, it been found that my condition is due to having a course of microneedling with PRP, treatments. I am devastated; my dermatologist believes I have solid facial oedema, which is very rare. I am now on Roaccutane & may need to be on it for 1-2 years; although my skin is responding, this will be a long battle to get rid of it. I’m completely shattered. I would NEVER recommend micro-needling to anyone. I warn all my friends about the micro needling risks so they never suffer like I am. Your Bio lipid has been a lifesaver I refer to it as liquid gold.”
For those of you who openly shared your microneedling before and after journey, thank you, we hope that together we can help rebuild the health of your skin.
If you are unfortunate enough to have suffered a severe reaction, next up, we will look at what can go wrong, so keep reading.
These interesting case studies (2) looked at people who suffered facial allergic granulomatous reactions and hypersensitivity associated with microneedling treatment.
Side Effects of Microneedle Treatment
1. My skin is inflamed, and I’ve developed rosacea.
Chronic inflammation is highly damaging.
By its very design, microneedling creates a measured degree of inflammation (depending on the depth of the needles), which is a normal, physiological response to the trauma.
Most mild allergic or inflammatory responses will go away after a week.
If you find that it persists, it could be because your immune system is trying to block a substance that it perceives as a foreign body that it can’t eliminate. This could be due to chemicals, organic and inorganic materials or bacterial infection.
The appearance of redness and swelling may not be visible to the naked eye at first, which can be misleading.
However, inflammation that makes your skin painful to touch could be taking its toll on the structural cells and matrix proteins within the dermis, the deeper layers of your skin.
It may also signify something more insidious and pathological such as rosacea or granulomatous dermatoses, which become apparent as the underlying infection or localised lesions inflame and distort tissues; this can take weeks or even months to develop.
Because it resembles skin changes associated with accelerated skin ageing, it’s referred to in the industry as “skin flamm’ageing”.
Furthermore, any plumping sensation that may occur is an illusion; this is merely your body creating inflammation, causing the area to swell.
When inflammation occurs, skin cells break down collagen, further accelerating ageing.
2. My skin looks prematurely aged, and wrinkles are appearing
When needles penetrate the dermis, the deeper layer of your skin, it creates an inflammatory response that boosts fibronectin production.
This glycoprotein creates a type of ‘scaffolding’ onto which the newly inducted collagen is deposited; over time, this collagen undergoes a conversion process where it naturally tightens up, which reduces wrinkles and helps resurface scars that may be present on your skin.
When you puncture your skin with needles, you rip at the collagen fibres, causing mechanical damage and desensitising the receptors responsible for signalling collagen synthesis; this is evident when clients say the first treatment was successful, but the subsequent treatments had the opposite effect.
The constant destruction of collagen through needling forces your body to produce new collagen fibres to replace it; over time, this natural ability becomes depleted, thus accelerating the ageing process.
It is important to note that when you are microneedling, it creates a stress response. When your body is exposed to this stressor – it quickly tries to replace the collagen that has been lost.
Whilst this may give the appearance of plump skin, the reality is that any underlying damage done to your skin’s internal scaffolding can show immediately or take years to manifest.
But the damage is done – lines and wrinkles, hollow areas and sagging skin all become increasingly apparent,
Cell death and telomere destruction
It’s worth noting that when you puncture your cells with needles, you damage the integrity of a healthy cell, causing cell death and, thus, accelerating the ageing process.
Cellular turnover occurs when skin cells are replaced by another live skin cell via cellular division.
When this happens, the end of the chromosome within the cell’s nucleus is cut off; this is referred to as a telomere; once 60 divisions have taken place, the telomere completely cuts off, and ageing begins.
Micro-needling accelerates the rate at which cell division occurs in your skin; the faster it happens, the more your skin ages, leading to sagging and expression lines.
3. My skin Becomes Inflamed When I Apply Products.
Microneedling dramatically disrupts your skin’s impermeable barrier function, which is made up of multiple layers of ‘dead keratinised cells which are there to protect your deeper, living cells.
The needles pierce through these layers, creating thousands of channels that enable topically-applied substances to penetrate.
The flip side is that until these channels form effective plugs and initiate the healing process, your skin is left wide open and vulnerable to anything it comes into contact with; yikes!
Many risks associated with this treatment are often unrelated to the needling procedure. They can be due to the topical solutions applied to the skin during maximal barrier function disruption.
Substances that are part of one’s normal physiology and found naturally within your skin are safe; substances that are not should be avoided.
This is why we only recommend “skin-identical hyaluronic acid” when you are in the healing stage, once healed, followed by a formula containing ceramides, lipids, cholesterol and fatty acids.
We created an entire article that discusses what happens when you micro-needle certain ingredients into your skin, which you can read here.
4. My skin was dry but is now oily and has an orange-peel texture.
When you microneedle your skin, you create hundreds to thousands of puncture holes in your skin, and although not visible to the naked eye, these holes are large enough to create pathways to your bloodstream.
Your skin sees this as trauma, and your sebaceous glands go into overdrive, causing your skin to become excessively oily.
Bacteria can get trapped in your pores, causing breakouts, and your skin takes on an uneven orange peel texture, almost like cellulite. These textural changes are usually due to low-grade inflammation caused by the needling.
Other issues include raised milia-like bumps, blackheads and extended pores.
5. I have horizontal track marks on my skin.
We are often asked if this is a normal side effect; here’s the long answer:
Suppose your esthetician was gentle and thorough and knew how to hold, position, and vary the penetration depth to prevent damage.
These marks reflect the pattern they used to get uniform coverage in different areas of your skin and should fade within a few days.
Complications arise due to “operator error” of the hand-held device, where too much pressure was applied over the bony areas. This can lead to bruising and tram-track scarring.
Interestingly this study (3) carried out by Yadav and Dogra also attributes this finding to nickel-contact dermatitis.
Cross-contamination is possible during this treatment, and if a microneedle or derma roller is used, the handpiece has the potential for backflow; that’s why hygienic practices are essential to minimise the risk of contamination.
6. I have dark patches and uneven skin tone.
Trauma to your skin can cause melanin – the pigment that causes colour changes – making it rush to the injury site, creating hyperpigmentation.
Anyone with a darker skin type, type 3 or higher on the Fitzpatrick scale, may be at risk of hyperpigmentation in response to inflammation.
Inexperienced practitioners won’t know to assess their client’s skin on the Fitzpatrick scale, which can also result in these pigmentation changes.
Another reason you need to be so careful about who you use to treat your skin is that this is a treatment that is not to be taken lightly.
7. Can needling trigger tumour formation?
The old school of thought was that old skin wounds were benign. This research (4) found that skin wounds can cause basal cell carcinoma, the most common type of skin cancer.
Its origins start in the basal cell layer, the lower part of the epidermis, and the cells of hair follicles. The formation of tumours occurs when errors in the follicular cell’s DNA cause unregulated cellular division, leading to tumorous growth.
It is understood that a wide range of wound-type injuries, even minor wounds like paper cuts, can activate cancer-provoking genes in your skin as it heals.
Reiter & Wong hypothesised that skin wounds might promote basal cell carcinoma. Their research (5) found that stem cells in hair follicles can transform into cancerous cells while healing an injury.
Reiter and wong state that scientists believe cancers are wounds gone awry. Usually, the hair follicle represses the tumour-generating potential of the stem cells, he says, but when these cells become unstable, trouble begins.
These findings are essential; Reiter & Wong found that the development of basal cell carcinomas is not exclusive to large wounds: even minor incisions could induce carcinomas – such as those created by micro-needling.
Micro-needling causes tiny wounds in your skin, which mobilises cells from the hair follicles to heal injuries; by mobilising these cells into the epidermis, your outer layer of skin can produce tumours.
How do I care for my damaged skin?
Will my skin ever recover after microneedling? It is a question we get asked daily.
Fortunately, there is hope; you can heal your skin damaged by microneedling, but how long it takes depends on the damage and how your skin responds to treatment.
Some clients’ skin heals in 6 to 12 weeks, in line with cellular turnover. For others, it can take longer, but it is achievable with the correct treatment protocol and effective ingredients.
Keeping it pure and simple is our mantra when treating your skin after a damaging micro-needling session;
We recommend using a consistent skincare regime with gentle topicals that are barrier-repairing.
You want to keep inflammation out of your skin as much as possible, so avoid using actives like Vitamin C and A until your barrier function repairs and your skin begins to heal.
Granulomatous reactions in response to the unauthorised use of topical products not approved for intradermal injection have been reported in three patients undergoing microneedling treatment in this study (6).
To Conclude. The naked truth
It’s true for some people, micro-needling is successful.
But surely we can’t ignore the number of people experiencing complications, including premature ageing, sagging skin, and changes in skin texture and conditions.
For instance, someone with once dry skin may now be experiencing oily skin, enlarged pores, and even breakouts,
They may also experience more severe side effects such as horizontal tract marks, permanent scarring and indentations or hyper and hypo-pigmentary changes in their skin.
Granulomatous infections are very serious. Initially, they don’t look like you think they should, and they can appear benign and subtle at first; signs you have such an infection is that your skin might be irritated and feel like it’s not healing.
This is because your body’s immune system is holding the offending bacteria, the pathogen, in partial check but isn’t strong enough to eliminate it so inflammation may be bubbling away under your skin’s surface.
The bottom line. Be careful with treating your skin; get a second or third opinion, and do your research well.
You are responsible for caring for your primary organ that protects you every second of your life.
If you are concerned, contact us here with photos, so we can review them and offer you the best advice moving forward.
Unintended widespread facial autoinoculation of varicella by home microneedling roller device.
- A Cutaneous Reaction to Microneedling for Postacne Scarring Caused by Nickel Hypersensitivity.
- Previous injuries or scars are risk factors for basal cell carcinoma development.
Mutant stem cells can cause skin cancer at cuts.
Facial allergic granulomatous reaction and systemic hypersensitivity associated with microneedle therapy for skin rejuvenation.